Low-income patients in Tacoma have sued MultiCare, alleging the hospital system failed to screen them for free or discounted care before sending them to debt collectors.

Joncee Hull and Sharon Shrout argue in their class action that they were underinsured, couldn't afford the MultiCare bills for treatment at Tacoma General Hospital and Mary Bridge Children's Hospital and should have qualified for so-called "charity care" under state law.

MultiCare subjected “uninsured and underinsured patients to collection efforts without first affirmatively screening them to determine their financial eligibility for free or discounted hospital care,” the lawsuit alleges.

Asked about the allegations, MultiCare said in a statement that it believes it is fully complying with the charity care law, and that the lawsuit "has no merit."

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According to the statement, "... both patients had health insurance. Under state law, when a patient has coverage, the hospital is permitted to bill insurance or other coverage sources, even if the patient is indigent. If the patient does not have insurance, or if insurance requires the patient to pay a portion of the bill, payment may be reduced or forgiven if the patient meets the criteria for charity care."

The MultiCare hospitals aren't the only local ones accused of mishandling so-called charity care.

The state's Charity Care Act says patients qualify for free or discounted care if their income is below 200 percent of the federal poverty level — $48,600 a year in the case of a family of four, according to the MultiCare suit.

It also requires hospitals to screen patients "at or near the time of service," the complaint states, and "before any collection efforts," to decide if they meet the threshold.

“The state of Washington legislated to try to help people that are indigent by making it mandatory to screen for indigent patients,” Abbas Kazerounian, one of their attorneys representing Hull and Shrout in the MultiCare suit, told The News Tribune. “It’s a very important policy lawsuit to make sure that indigent patients are treated fairly by Washington law in the future.”

The complaint, filed May 3 in U.S. District Court, seeks “recovery of excess payments” that the patients made to MultiCare, unspecified damages under the state’s Consumer Protection Act and that MultiCare be required by the court to comply with the Charity Care Act.

The suit gives this account of Hull's and Shrout's interactions with MultiCare:

Hull, a 40-year-old mother with multiple children, works as a front office supervisor at a hotel.

She had her gall bladder removed at Tacoma General in May 2016, after which MultiCare sent her to collections without screening her for charity care and without contacting her about the bill.

Hull alleges the first she heard about the matter was when a collection agency contacted her.

Shrout, a 38-year-old recruiter for a technology company, brought her daughter to Mary Bridge Children on May 2, 2017, for treatment of an injury.

Shrout was sent to a debt collector, without MultiCare screening her for charity care.

Citing the pending litigation, attorney Kazerounian said he didn’t want to discuss specific's of the daughter's injury, or the cost of the hospital bills for Hull or Shrout.

MultiCare's statement said its hospitals tell patients about charity care and other financial assistance throughout registration and billing. It also argued that MultiCare's charity care is above state and regional averages.

"In 2016, our charity care represented 5.5 percent of adjusted revenue, well above the state average of 4.4 percent, and we helped 34,996 patients receive financial assistance with $101 million in bills for care at a MultiCare hospital or clinic," the statement said.